Abstract
IntroductionSingle coronary artery is a rare anomaly, which is usually associated with other cardiac congenital abnormalities.Case ReportA 56-year-old female presented with unstable angina. The patient reported complaints of typical chest pain on exertion few months prior to presentation, which progressed to become at rest. The pain was associated palpitations and dizziness. Past medical history was significant for hypertension and hyperlipidemia. Vital signs were stable. Physical examination was non-remarkable. Electrocardiogram showed normal sinus rhythm, with intermittent episodes of sinus bradycardia, and non-specific T-wave changes. Trans-thoracic echocardiogram showed normal left ventricular function and no segmental wall-motion abnormalities. Selective coronary angiography showed a normal left main coronary artery arising from left coronary cusp. The left main branched to a normal left anterior descending artery and to the left circumflex artery; a large vessel which supplied also the territory of the right coronary artery (RCA) through its terminal extension. Aortography showed absence of RCA with no other vessels arising from the right or non-coronary cusps. The patient was managed conservatively and discharged home with resolution of symptoms.ConclusionsWe report a rare case of isolated single coronary artery with absent RCA. The patient presented with unstable angina, and was managed conservatively. Cardiologists should be aware of this rare condition, which carries a potential risk of sudden cardiac death.
Highlights
Single coronary artery is a rare anomaly, which is usually associated with other cardiac congenital abnormalities
We report a rare case of isolated single coronary artery with absent right coronary artery (RCA)
Cardiologists should be aware of this rare condition, which carries a potential risk of sudden cardiac death
Summary
Single coronary artery (SCA) is a rare congenital anomaly where only one coronary artery arises. Cardiol Ther (2018) 7:119–123 from a single coronary ostium to supply the entire heart [1, 2] It is usually associated with other cardiac abnormalities. The patient complained of progressive substernal chest pain on exertion that started a few months prior to presentation, and progressed to become more frequent and at rest Selective coronary angiography (Fig. 1a) showed a normal left main coronary artery arising from the left coronary cusp, branching to a normal left anterior descending artery (LAD) and to a left circumflex artery (LCX) The latter was a large vessel that supplied the territory of the right coronary artery (RCA) through its terminal extension. Informed consent was obtained from the patient for reporting this rare case
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